The recent suicide of Jeffrey Epstein has brought increased media attention to suicide and suicidal ideation. The Centers for Disease Control and Prevention (CDC) identifies suicide as a dangerous public health problem that has long-lasting effects on families and communities.  The CDC is taking active steps to reduce the incidence of suicide.  In the general population, completed suicide has a rate of 12/100,000 individuals.  It is documented that women are about 10 times more likely to attempt suicide as compared with men, but that men are about 4 times more likely to complete suicide.

Specific risk factors include age, race, gender, chronic medical illness, psychiatric illness, and substance abuse.  White men commit nearly 75% of all suicides.  The rate of suicide increases dramatically in the 70th decade of life, especially in white men.  At least 50% of patients that commit suicide have a documented history of depression and about 25% have a history of alcoholism or drug use.

It is important to remember that the risk for suicide is never zero, and that patients reporting suicidal thoughts and ideation should always be taken seriously. The individual should not be left alone, and they should not have access to any weapons or medications, including full-sized bottles of acetaminophen or NSAIDS. Any patient exhibiting suicidal thoughts or ideations should be evaluated by a provider trained in psychiatry. Many online and phone resources are available.  For example, the CDC provides and online chat and a live call-in number.  If the patient refuses to be seen by a provider or to receive help, such as going to the emergency department, emergency services should be called. 

 Centers for Disease Control and Prevention (CDC): Suicide

Principles and Practice of Hospital Medicine, 2e: Chapter 227: The Suicidal Patient

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